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• <br />0 <br />• <br />City of South Bend Special Event Application <br />Neighborhood Event <br />$25 application fee if filed 30 days or greater (up to 180 days) in advance of event. <br />Please Brine Completed Application and Payment to: <br />Public Works Service Center, 731 S. Lafayette Blvd., South Bend, IN <br />Review the Instructions on the Special Events page before completing the application. Neighborhood Special <br />Event applications must be submitted more than 30 days in advance of the event date or the application will not <br />be accented. <br />Section A - Aoplicant Information / <br />Date of Application: l' 7-� 2 -� L/ n Organization Name: +%4 LLL $N J�W od <br />Applicant (Contact) Name:_C �, nl nr ! & %V'M Ap— <br />Applicant(Contact)Phone:,S 7Y'.i3%_T Contact Email��+'� 4Y Q ota <br />Address: D. v // 6�` City/State/ZIP: f 7_� y&_' 3�1 <br />Secondary Contact <br />Contact Phone: <br />Contact Email: <br />Address: City/State/ZIP: <br />Event Name: _&& Qt wb i dr) Expected Attendance: <br />Requested Street Closure: C.v S 1,.A i <br />From (Cross Street): r41Ga.q Sf <br />To (Cross Street): % cCzr- cS! <br />Provide a brief description of the event: <br />Date of Event Setup [mm/dd/yy]: d Time: <br />Begin Date of Event [mm/dd/yyl: n LQ 3 ' V Time: ,yd'-:�n /yam <br />End Date of Event [mm/dd/yy]: 0 F- 5 3 - L`/ Time: <br />Event Cleanup Completion [mm/dd/yy): 6 �'- 6 Time: <br />Have all residents on the affected block have been notified and invited? UYes []No <br />Please attach a copy of the door hanger or letter used to notify residents in addition to signature attachment. <br />Number of households fronting the proposed street closure: <br />Number of households represented by signatures on attached sheet: <br />Will this event have music (live or other)? V Yes 0 No <br />